Attia Sameh Gabr
M.D., Assistant Professor, Department of surgery, Faculty of Medicine, Alazhar University, Cairo-Egypt.
Electron Physician. 2017 Jan 25;9(1):3529-3534. doi: 10.19082/3529. eCollection 2017 Jan.
The aim of this study was to evaluate the Laparoscopic Sleeve Gastrectomy (LSG) with simultaneous crural repair in treatment of morbid obesity associated with gastroesophageal reflux disease.
This prospective observational study was carried out from September 2012 to July 2016 in Al-Azhar University Hospital (Egypt). The study was conducted on 53 patients, 14 males (26.4%) and 39 females (73.6%) with the mean age 36.2 years (range 18-52 years), presenting with morbid obesity and reflux disease either symptomatic patients or asymptomatic (Endoscopic & Manometric), their mean Body Mass Index (BMI) was 50.1 kg/m (range 40-62 kg/m), who underwent LSG and antireflux procedure (crural repair).
Excess weight Loss (EWL); the mean EWL at 6 months postoperatively was 46.3%, at 12 months was 54%, and at 18 months was 61%. Also, we found that, preoperative co-morbidities are resolved by 53% and improved by 23%. Reflux symptoms were absent in 30 patients (56 %), improved in 14 patients (26.4 %), but persistent in 7 patients (13.2 %).
Laparoscopic crural closure, during LSG, represents a valuable option for the treatment of morbid obesity and gastroesophageal reflux, and can result in favorable outcomes in terms of weight loss and gastroesophageal reflux disease (GERD) symptoms control.
本研究旨在评估腹腔镜袖状胃切除术（LSG）联合同时进行的膈肌脚修复术治疗与胃食管反流病相关的病态肥胖症的效果。
本前瞻性观察性研究于2012年9月至2016年7月在开罗大学医院（埃及）开展。该研究纳入了53例患者，其中14例男性（26.4%），39例女性（73.6%），平均年龄36.2岁（范围18 - 52岁），均患有病态肥胖症且伴有反流病，包括有症状患者或无症状患者（通过内镜及测压检查），他们的平均体重指数（BMI）为50.1kg/m²（范围40 - 62kg/m²），均接受了腹腔镜袖状胃切除术及抗反流手术（膈肌脚修复术）。
超重减轻（EWL）；术后6个月时平均EWL为46.3%，12个月时为54%，18个月时为61%。此外，我们发现，术前的合并症有53%得到解决，23%有所改善。30例患者（56%）反流症状消失，14例患者（26.4%）症状改善，但7例患者（13.2%）症状持续存在。
在腹腔镜袖状胃切除术中进行腹腔镜膈肌脚闭合术，是治疗病态肥胖症和胃食管反流的一种有价值的选择，在减重和控制胃食管反流病（GERD）症状方面可取得良好效果。
